Haiti Case Study - The Department of Global Health and Social ...

95. The most prominent challenge that hampers a coherent and effective response by the
security, humanitarian and the development communities is insufficient coordination
mechanisms at national/international political level to include the whole spectrum of
governmental stakeholders (uniformed or not) in achieving a common goal. Military
initiatives to develop venues on how to contribute to a comprehensive approach are not
currently being fully supported by civilian actors either from the security or humanitarian and
development communities, which leaves the military alone in crafting a concept for civilmilitary
interaction in crisis affected fragile states.
96. The point that we will take forward in subsequent case studies is to look for ways that
members of the security, humanitarian & development community are incorporated or could
be better incorporated into policy, plans and standing mechanisms for interaction.
Health System Recovery – short- versus long-term approach
97. The activities of the security community responding to the earthquake and the cholera
outbreak were not designed to strengthen the health system as those activities were ad hoc
efforts to fill the gaps left by an overwhelmed humanitarian and development community.
When considering the amount of human and financial effort invested in Haiti after the two
shocks to the health system, the discussion remains on how global actors should balance
their contribution by providing emergency aid (curing the symptoms) or how to support longterm
and sustainable infrastructural developments (addressing the cause).
98. The concept of “early recovery” after disaster has evolved over the past ten years.
Conventionally, recovery and delivery of humanitarian assistance has been conceived of as
distinct sets of activities that take place during different time periods. However, a new
paradigm has emerged which recognizes the link between population survival strategies,
which largely rely on attempts to access pre-disaster resources and systems, and aid
distribution and reconstruction. 76 The IASC evaluation of the Haiti response summaries this
new paradigm:
“In a sudden-onset disaster…early recovery often starts the day after…Early recovery
activities are critical to the wider strategizing on the overall objectives of the humanitarian
response. In Haiti, for example, what happens, and where, in terms of job creation,
provision of school and development of services will have significant impact on decisions
relating to resettlement and longer term support.” 77
99. By most accounts, initiating early recovery activities within the first 24 hours after an
emergency has yet to find significant expression in the field. Most reviews of the Haiti
response note this is an underappreciated notion of early recovery and its link to relief and
reconstruction on the part of the response community generally 78 . Protection and recovery of
the health system seems to have been missing from the mandates of most early response
organizations. This was true of military responders in Haiti whose mandates tended to be
only relevant to providing direct relief.
100. In situations like Haiti when hundreds of actors are independently providing various
types of direct and indirect care, it still remains unclear how this effort leads into long-lasting
support that results in a sustainable indigenous health care system.
101. The point that we will take forward in subsequent case studies will be to look for ways
and concepts that can better relate crisis response to longer term recovery and health
system strengthening.
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